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Intratumoral Cisplatin for Resectable NSCLC

20 maj 2022 uppdaterad av: C. Matthew Kinsey MD, MPH, University of Vermont

A Phase 1 Trial of Intratumoral Cisplatin for Early Stage, Resectable, Non-Small Cell Lung Cancer

PRIMARY OBJECTIVE:

To identify the maximum tolerated dose (MTD) of intratumoral cisplatin, delivered during a single bronchoscopy with cone-beam CT confirmation, in a dose escalation protocol

DESIGN: 3+3 dose escalation.

Studieöversikt

Status

Rekrytering

Detaljerad beskrivning

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death in the United States. Even for early stage disease, the rate of recurrence following surgical resection is as high as 50%. Although neoadjuvant therapy, administered before surgery, for early stage lung cancer is associated with a survival benefit, it is rarely used due to the systemic toxicity of intravenous (IV) cytotoxic chemotherapy. IV immunotherapies are also being evaluated in combination with systemic therapies in the neoadjuvant setting. However, only a minority of patients respond to immunotherapy. One of the most common reasons for failure of immunotherapy is lack of presentation of tumor antigens to the immune system, a problem that may be potentially addressed with cytotoxic agents.

Over the last several years, case series have demonstrated the feasibility and safety of delivering cisplatin directly into lung tumors. Given the current knowledge of safety and tolerability of intratumoral cisplatin, coupled with the potential to achieve immune priming that may help address systemic micrometastases, the investigators postulate that intratumoral cisplatin will be well-tolerated, and potentially effective, neoadjuvant therapy for patients with early stage, resectable, non-small cell lung cancer.

Studietyp

Interventionell

Inskrivning (Förväntat)

10

Fas

  • Fas 1

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • Age ≥18 years.
  • Eastern Cooperative Oncology Group performance status 0 or 1
  • Patients must have adequate organ and marrow function as defined below:

    • Leukocytes ≥3,000/microliter
    • Platelets ≥100,000/microliter
    • Total bilirubin ≤ institutional upper limit of normal (ULN)
    • Aspartate aminotransferase /Alanine aminotransferase ≤3 × institutional upper limit of normal
    • Creatinine ≤ institutional ULN
  • Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial
  • Have known or suspected clinical stage I-IIb NSCLC after computed tomography (CT) and/or positron emission tomography at time of enrollment
  • Presence of a target lesion with a minimum volume of 1.0 cm3, (approximately1.2 cm in diameter) and ≤ 5.0 cm in diameter
  • Agreement from a cardiothoracic surgeon, following review of past medical history, medications, pulmonary function testing, and CT scan that patient is likely to be a surgical candidate and that, after considering known possible adverse events, delivery of intratumoral cisplatin is unlikely to adversely affect surgical feasibility
  • Rapid on-site cytopathologic examination (ROSE) performed during the procedure returns likely NSCLC (per the determination of a trained, attending, cytopathologist). No research procedures will be performed if ROSE is non-diagnostic
  • A CT scan of the chest (with or without contrast) within 1 month of the screening visit
  • Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

  • Use of an investigational agent within 30 days of the screening visit
  • IV chemotherapy within the 30 days of the screening visit
  • Pregnancy/lactation (pregnancy test to be performed by pre-op as part of standard of care for women of child-bearing age as defined by University of Vermont Medical Center Policy
  • History of prior radiation to the study lesion
  • History of allergic reaction to cisplatin or its derivatives
  • Patients with uncontrolled intercurrent illness
  • Physician determination that patient would not be appropriate for study

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Intratumoral Cisplatin Arm
Single arm approach. There is no comparator or placebo group. Cisplatin will be administered directly into a non-small cell lung cancer, following imaging verification and pathologic diagnosis, during a single bronchoscopic procedure.
Cisplatin delivered bronchoscopically at the time of diagnosis of NSCLC
Andra namn:
  • cisplatin

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Rate of dose limiting toxicity
Tidsram: Within 2 weeks of delivery
Adverse events as defined using the Common Terminology Criteria for Adverse Events
Within 2 weeks of delivery

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Major pathologic response
Tidsram: Assessed on the surgical resection specimen, performed within 30 days of bronchoscopic delivery
Evaluation of the tissue response to the drug
Assessed on the surgical resection specimen, performed within 30 days of bronchoscopic delivery
Blood biomarker panel
Tidsram: Assessed from blood drawn on day of bronchoscopy and day of surgical resection
Includes serum cytokine analysis, mass cytometry for inflammatory cells, and complete blood count
Assessed from blood drawn on day of bronchoscopy and day of surgical resection
Tissue biomarker panel
Tidsram: Assessed from tissue obtained on day of bronchoscopy and day of surgical resection
Includes evaluation of cellular constituents and sequencing of cells present in tissue
Assessed from tissue obtained on day of bronchoscopy and day of surgical resection

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Samarbetspartners

Utredare

  • Huvudutredare: C. Matthew Kinsey, MD, MPH, University of Vermont

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

8 mars 2021

Primärt slutförande (Förväntat)

1 mars 2024

Avslutad studie (Förväntat)

1 september 2024

Studieregistreringsdatum

Först inskickad

8 mars 2021

Först inskickad som uppfyllde QC-kriterierna

18 mars 2021

Första postat (Faktisk)

22 mars 2021

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

23 maj 2022

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

20 maj 2022

Senast verifierad

1 maj 2022

Mer information

Termer relaterade till denna studie

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Ja

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

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